Mandated Benefit for Early Intervention

Eleven states mandate that both private and public insurers cover early intervention services for children age 0-3 with or at risk for developmental delays. In MA and RI the benefit is capped at $5000-$5500 for privately insured children, but this means that state and federal funds for early intervention can be reserved to cover uninsured children or privately insured children who need services in excess of the benefit cap. The net effect is to ensure nearly universal access to early intervention services for young children.

STRATEGIC SPENDING

Learn how some states use particular financing strategies


Care Coordination: Integrating Title V and Medicaid Funding
Catastrophic Relief or Trust Funds
Comprehensive Health Care Reform
Consumer/Family-Directed Care Models

Disease Management Programs

Early Periodic Screening, Diagnosis and Treatment (EPSDT)

Family Partnership
Flexible Funding

High-Risk Pools/Re-Insurance
Home and Community Based Service Waivers (1915c waivers)

Integrated Delivery Models for Targeted Diagnoses or Populations
Interagency Collaboration

Managed Care Purchasing Specifications
Mandated Benefits
Maximizing Private Coverage/Benefits Counseling
Medicaid Buy-In Programs

Outreach, Identification and Enrollment Strategies

Pay for Performance
Premium Assistance Programs
Primary Care Case Management (PCCM) and Fee-for-Service Payment Enhancements
Private Sector Initiatives
Providing Access to Day Care and Camps
Public/Private Partnerships

SCHIP and Enhanced SCHIP Benefits
Specialty Managed Care Plans

TEFRA and TEFRA Look-Alike Programs
Telemedicine
Transition Services for Youth